Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a clinical term for a condition that affects the way people are able to communicate, interact socially, and behave. The disorder can impact how people function to varying degrees, which is why the word spectrum is used.

While the factors underlying ASD are very complex, it is generally thought that an interaction between genetic components and environmental influences affects a person’s likelihood of developing the disorder.

Risk factors for developing ASD include:

  • Having a sibling with ASD
  • Older parents
  • Particular genetic or chromosomal conditions
  • Very low birth weight, or born prematurely

The symptoms of ASD are present from early childhood and it is a lifelong condition. If you have concerns about your child (or yourself), it is important to seek assessment as early as possible, so that a diagnosis can be considered, treatment can start, and the right kinds of supports put in place. This can make a huge difference in helping people to lead very fulfilled and rewarding lives.

While ASD is the source of many challenges for people with the diagnosis, it can also be a source of strength. Therapy can help to develop this more positive side of ASD.

Types of Autism Spectrum Disorder

Many different labels have been used over the years to describe the kinds of experiences and symptoms of ASD. You may have heard of some of them before, like Asperger Syndrome.

Because of recent changes to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), you’re now more likely to hear health professionals use the term Autism Spectrum Disorder to encompass all of the different types of symptom combinations and severity.

Prevalence of Autism Spectrum Disorder

According to estimates from the CDC, 1 in 59 children in 2014 had been identified with ASD by the age of 8. [1]

Diagnosis rates appear to be increasing, although it is difficult to tell why this may be the case. For example, the huge increase in awareness of ASD could be a factor that is influencing the more frequent diagnosis.

Data also suggests that ASD is more frequently identified in males than females. Again, it’s difficult to pinpoint why this might be the case. For example, it may be that females tend to handle symptoms differently, leading to less frequent diagnosis of ASD.

Symptoms of Autism Spectrum Disorder

Because ASD is a spectrum disorder, people may experience different combinations of symptoms of differing severity. According to the DSM-V, the kinds of symptoms that people with ASD experience are:

Difficulty communicating and interacting with others

  • Rarely initiating social interactions, or appearing less interested in people and social interactions
  • Difficulty making friends and relating to people
  • Difficulty participating in the usual back-and-forth reciprocal nature of conversation
  • May not notice social cues or experience difficulty interpreting them
  • Tending not to share interests or emotions

Restricted interests and repetitive behaviors

  • Repetitive movements or repeating particular words or phrases
  • Being less flexible and comfortable with change; feeling distressed when small changes occur
  • Sticking strictly to routines
  • Fixated and intense areas of interest
  • More (or less) sensitive to stimulation from the environment. For example, feeling distressed at particular noises or being particularly fascinated by something visual.

Assessment and Diagnosis of Autism Spectrum Disorder

It is possible for features of ASD to be noticeable by the age of 2. Parents with concerns about their child’s behavior can talk to their physician, who can help to organize an assessment. It’s often more difficult to diagnose ASD in adults, but if you have concerns you should also speak to your doctor.

The assessment and diagnosis of ASD are fairly specialized. The process often involves a comprehensive review by a team of professionals, which may include a pediatrician, child psychologist or psychiatrist, neuropsychologist, and/or a speech pathologist.

Autism Spectrum Disorder treatment

With the right treatment and supports in place, people with ASD can go on to lead very fulfilling lives, even though there is no "cure" for the disorder.

Treatment plans for ASD tend to involve a combination of approaches including medication, skills training, therapy, and other supports.

Unfortunately, it’s not uncommon for people experiencing ASD to also experience mental health problems such as anxiety or depression. As such, it’s important to work closely with your health care professional to figure out the treatment approach that’s the right fit for you. Common elements of a treatment plan include:

Medication

Some of the symptoms of ASD and any associated mental health problems can be managed successfully with medication. Medications may be prescribed by a specialized doctor to help with:

  • Difficulty sleeping
  • Low mood, irritability, or anger
  • Aggressive behavior
  • Difficulty paying attention

Therapy

Therapy for ASD is usually targeted, highly structured, and aims to help people to cope better and function at their best. Applied Behavior Analysis (ABA) is an evidence-based type of therapy commonly used. ABA helps build positive behaviors and discourage unhelpful behaviors. It also focuses on skills training, which helps people with ASD with:

  • Communication
  • Social interaction
  • Academic or occupational skills, to help children to succeed at school, or adults to succeed at work

In addition, people who are also experiencing mental health problems, such as anxiety, depression, or obsessive compulsive disorder (OCD) may benefit from extra targeted therapy.

For example, modified Cognitive Behavioral Therapy (CBT) can help change unhelpful thoughts and behaviors. Family counseling can be helpful for managing the challenges of living with someone with ASD.

Support groups

Many people with ASD and parents of children with ASD find Autism support groups to be highly beneficial. Even the sharing of experiences in support groups can help people with ASD to feel that they are not alone.

What to look for in a therapist for Autism Spectrum Disorder

As discussed above, treatment for ASD is usually undertaken by a team of health professionals of many disciplines. When selecting a mental health professional to provide the therapy component of treatment for ASD, it can be helpful to consider the following factors:

  1. Personal fit: As is the case when you are seeking therapy for any reason, it’s important to consider the potential for developing a strong working relationship with your therapist. This can be particularly challenging yet important for people with ASD who can have social and communication difficulties. Consider asking for help from trusted family members, friends, or your doctor, in helping to identify a therapist who would be a good fit for you.
  2. Qualifications: Be sure that you find a licensed mental health professional. Ask your prospective therapist ahead of time whether they have specialized training in ABA, as this will be extremely beneficial in therapy.
  3. Experience: Look for a therapist who has previous experience working with people with ASD. Therapists will often specialize in this ASD, and often note this in their biographies to help you to identify them in your search.

Sources:
1: https://www.cdc.gov/ncbddd/autism/data.html